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Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.

Proctor E, Luke D, Calhoun A, McMillen C, Brownson R, McCrary S, Padek M - Implement Sci (2015)

Bottom Line: This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.Implementation science needs to pursue later-stage translation research questions required for population impact.Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

View Article: PubMed Central - PubMed

Affiliation: George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus, Box 1196, St. Louis, MO, USA. ekp@wustl.edu.

ABSTRACT

Background: Little is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.

Methods: A multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care.

Results: Prompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research.

Conclusions: Implementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

No MeSH data available.


Related in: MedlinePlus

Sustainability Research Landscape
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
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Fig1: Sustainability Research Landscape

Mentions: The CM process generated 11 clusters of ideas, labeled by the core team as the “Sustainability Research Landscape” (see Fig. 1). Table 1 presents the items and item loadings associated with each cluster. A CM’s stress value reflects the discrepancy between the original sorting data input by the users and the distances on the two-dimensional point map. Our map’s stress value of 0.32719 after six iterations fits well within the range established in other CM research and indicates that our map has good fit to industry standards [30].Fig. 1


Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.

Proctor E, Luke D, Calhoun A, McMillen C, Brownson R, McCrary S, Padek M - Implement Sci (2015)

Sustainability Research Landscape
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4494699&req=5

Fig1: Sustainability Research Landscape
Mentions: The CM process generated 11 clusters of ideas, labeled by the core team as the “Sustainability Research Landscape” (see Fig. 1). Table 1 presents the items and item loadings associated with each cluster. A CM’s stress value reflects the discrepancy between the original sorting data input by the users and the distances on the two-dimensional point map. Our map’s stress value of 0.32719 after six iterations fits well within the range established in other CM research and indicates that our map has good fit to industry standards [30].Fig. 1

Bottom Line: This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.Implementation science needs to pursue later-stage translation research questions required for population impact.Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

View Article: PubMed Central - PubMed

Affiliation: George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus, Box 1196, St. Louis, MO, USA. ekp@wustl.edu.

ABSTRACT

Background: Little is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.

Methods: A multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care.

Results: Prompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research.

Conclusions: Implementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

No MeSH data available.


Related in: MedlinePlus